Guiding You Through the Insurance Process
At Austin Plastic & Reconstructive Surgery, our office will communicate with your health insurance provider up front and check on what exactly is covered so you know the actual out-of-pocket cost of surgery. There is an experienced team of administrators in our plastic surgery practice who handle insurance claims. Two of our team members are breast cancer survivors themselves and have a special perspective on the process. We use specific language and codes to indicate medical necessity and work to obtain prior authorization before surgery.
As our practice specializes in advanced breast reconstruction techniques, we are often able to obtain an insurance coverage exception for patients who are with an out-of-network insurance plan, called a "gap exception."
Remember that you'll still be responsible for your deductible and copays. If you're responsible for a portion of the treatment cost, this might influence your decisions about what type of reconstruction to have. Costs can vary widely, but implant procedures generally cost less than tissue flaps. However, they're more likely to require adjustment in the future, so the overall cost may even out.
